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OPP 4 > 10- Obstetrical Patient: Osteopathic and Manipulative Care [Wallace] > Flashcards

10- Obstetrical Patient: Osteopathic and Manipulative Care [Wallace] Flashcards

1
Q

Which is not a stressor of pregnancy?

a) mechanical
b) physiological
c) lymphatic
d) venous
e) hormonal
f) neurological
g) physiological
h) social

A

ALL OF THEM ARE!

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2
Q

Which are important creators or results of mechanical stressors in pregnancy?

a) shift of center gravity anteriorly / postural changes
b) Center of gravity changes / organ hypotrophy
c) Increased lumbar lordosis / increased cervical kyphosis
d) placement of uterus on other organs / non-system wide postural changes

A

a) shift of center gravity anteriorly / postural changes

NOT

b) Center of gravity changes / organ hypotrophy
- -> organ HYPERtrophy

c) Increased lumbar lordosis / increased cervical LORDOSIS
d) placement of uterus on other organs / non-system wide postural changes

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3
Q

What is the most common complaint in pregnant women?

A

low back pain (60%)

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4
Q

Low back pain is the most common complaint in pregnant women. What causes low back pain in pregnant women?

a) increased lumbar lordosis
b) shortening of lumbar musculature
c) increased need to support anterior shift in weight
d) all of the above

A

d) all of the above

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5
Q

Which is more common in a pregnant women?, herniated lumbar disc or bulging lumbar discs?

A

bulging lumbar discs

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6
Q

T or F: True radicular pain occurs more often early in pregnancy.

A

FALSE: True radicular pain occurs more often LATE in pregnancy.

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7
Q

In pregnancy, SI joint dysfunction is also common, what other changes do you see?

a) bilateral changes
b) trunk extensors pulling back on the sacrum
c) pain radiating down to the posterior thigh in a piriformis type of presentation (pain stops at the knee) w/o radiculopathy pattern
d) all of the above
e) none of the above

A

d) all of the above

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8
Q

Which of the following statements are true about pregnant women?

a) lightening pains are pains seen in the 3rd trimester
b) lightning pains can cause shooting pains or dull pubic pains
c) it is not caused by pressure on neural plexus

A

a) lightning pains are pains seen in the 3rd trimester

lightning pains appear as sharp or shooting pains

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9
Q

Rotoscoliosis is?

A

Curvature of spine WITH rotation effect on the body

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10
Q

In pregnancy, what kind of curvatures are increased?

A

AP (rotatory). Lateral (scoliatic) are not increased

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11
Q

Is there increased prematurity in mothers with rotoscoliosis?

A

Possibly

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12
Q

Is rheumatoid arthritis normal during pregnancy?

A

Yes. Tends to go away 6 weeks post partum.

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13
Q

[TQ!] What is a ABSOLUTE COMPLICATION of HVLA during pregnancy?

A

HVLA of AA joint due to rheumatoid arthritis!!! Can paralyze them!!!!!!!

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14
Q

Pts with ankylosing spondylitis may have ossification of what joint?

A

The SI joint.

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15
Q

What statements are false regarding some stresses that occur in pregnancy?

a) In pregnancy, an increase of interstitial fluids can be at volumes of 6.5 L, which will cause edema, is a physiological stress
b) There is a decrease in the efficiency of excess fluid removal the further along in pregnancy (worst in the 3rd trimester)
c) The size of the uterus can directly press the nodes, including periaortic, cervical and vaginal nodes
d) Edema, Headache, Nausea and Lightheadness are all part of congestion of one way valves in the azygous system of CNS.
e) none of the above

A

e) none of the above;

ALL of the statements are true.

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16
Q

[TQ] What is the #1 sign of venous congestion in pregnant ladies?

A

headache

17
Q

What statements are false regarding some stresses that occur in pregnancy?

a) Progesterone is an hormone stress increases with pregnancy and causes fluid retention, inc. chest circumference, subcostal angle widening, and diaphragm pushing superiorly as tidal volume increases.
b) hormonal changes encourage ligamentous changes causing loosened ligamentous structures, causing a change of the restrictional barrier to be closer to the anatomical barrier.
c) Relaxin is a hormone that promotes the relaxation of the ligaments and it is in the body from 10-12 weeks up to 8 weeks post partum.
d) Venous pains worsens especially during the day due to the upright position
e) none of the above

A

d) Venous pains worsens AT NIGHT especially a due to the SUPINE position

18
Q

[BOARD TQ] What is the sympathetic viscersomatic for the ovaries? via what

A

T 10-T11; superior mesenteric ganglion

19
Q

[BOARD TQ] What is the sympathetic viscersomatic for the fallopian tubes, uterus, and vagina?

A

T 11- T12 ; inferior mesenteric ganglion

20
Q

[BOARD TQ] In a pregnant lady, the parasympathetic Pudendal n viscerosomatics are located where?

A

S2- S4

21
Q

[TQ] What are contraindications to OMT in preganncy?

a) Premature rupture of membranes (PROM)
b) Premature labor
c) Abruptio placenta
d) Ectopic pregnancy
e) Placenta previa
f) none of the above
g) all of the above

A

g) all of the above

22
Q

[TQ] Which are not contraindications to OMT during pregnancy?

a) undiagnosed vaginal bleeding
b) prolapsed umbilical cord
c) threatened or incomplete abortion
d) severe pre-ecamplsia/eclampsia
e) all of the above
f) none of the above

A

f) none of the above

23
Q

In the first trimseter of pregnant patient, what do you want to do with the patient?

a) get a baseline postural exam, and have monthly visits to see the onset of somatic changes
b) recommend the patient do all the aggressive and active things they want to do now before she gets unable to do anything with kids
c) See the patient weekly to help build psychological support and help lymphatic flow to try to assist pelvic function
d) Evaluate pelvic diameters to anticipate pregnancy chambers

A

a) get a baseline postural exam, and have monthly visits to see the onset of somatic changes

24
Q

In the pre-delivery phase (36 weeks to delivery) of a pregnant patient, what do you want to do with the patient?

a) get a baseline postural exam, and have monthly visits to see the onset of somatic changes
b) recommend the patient do all the aggressive and active things they want to do now before she gets unable to do anything with kids
c) See the patient weekly to help build psychological support and help lymphatic flow to try to assist pelvic function
d) Evaluate pelvic diameters to anticipate pregnancy chambers
e) c and d

A

e) c and d

25
Q

T or F: If you are evaluating the lumbar-sacral region, should you augment the sacral movement in each contraction as an indirect treatment to help labor

A

True

26
Q

During labor, which of the following are true?

a) if labor is bilaterally flexed / occiput stays anterior on presentation
b) bilateral extended sacrum / occiput posterior presentation
c) entire sacrum anterior (flat pelvis)/no rotation on engagement
d) all of the above

A

d) all of the above

27
Q

[TQ] A 39 yo pregnant comes in complaining of pain going down the leg and thigh. During giving birth, she heard a pop and now she has pain while urinating. You check for urinary infection, and it’s negative. What do you think happened?

A

rupture of the pubic symphysis!!

28
Q

When is the final visit for post-partum pregnancy? What should you do at this time?

A

6 weeks! Don’t forget to check CRANIAL on the baby!

29
Q

Are herniated discs common during pregnancy?

A

NO.

30
Q

What type of scoliotic curves get worse during pregnancy?

A

AP curves. Lateral curves do NOT get worse.

31
Q

How is CNS flow affected during pregnancy?

A

It DECREASES

32
Q

What are the contraindications to OMT during pregnancy?

A 
Premature membrane rupture
Premature labor (relative)
Abruptio Placenta
Ectopic Pregnancy
Placenta previa
Undignosed vaginal bleeding
Prolapsed umbilical cord
Incomplete abortion
Severe pre-eclampsia/eclampsia
33
Q

What kind of sacrum dysfxn may require a C-section?

A

An ANTERIOR sacrum

34
Q

What type of sacrum dysfxn may allow for a posterior occiput presentation?

A

Bilateral extended sacrum

35
Q

What are the symptoms of venous congestion?

A

Edema, HEADACHE (Cephalgia), Nausea, Lightheadedness

36
Q

What innervations innervate pelvic structures during pregnancy?

A

Pudendal Nerves, Vagus, Superior Mesenteric Ganglion, Inferior Mesenteric Ganglion,

OPP 4 (14 decks)

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